heart carved into wood

Is Angioplasty For You?

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By Dr. Dean R Silver MD

Angioplasty involves the insertion of a catheter into the patient’s blocked coronary artery and the inflation of a tiny balloon once in the artery to open and restore blood flow to the heart. Doctors have recommended the procedure when plaque build-up in the coronary artery begins to cause chest pain. They maintain that a stent will reduce the likelihood of major cardiovascular events in the future.

You are probably a candidate for angioplasty if you continue to have physical symptoms that are interfering with your quality of life despite conventional and alternative therapies. Some of these symptoms include chest pain, shortness of breath, and feeling profoundly weak upon exertion, or palpitations or lightheadedness.

If you have stenosis, that is disease of the major blood vessels, that supply to a large area of the heart and feeds many blood vessels, you are probably a candidate. If your left main coronary artery is blocked 70% or more, in which case you should have surgery, whether or not you are symptomatic, and lately you had a recent heart attack, and a positive nuclear treadmill test with profound EKG changes with or without symptoms, showing your heart is at risk of further injury.

In less complicated terms, an angioplasty stent procedure is warranted for patients showing signs of a heart attack or advancing, unstable coronary disease. In the case of acute coronary syndrome, which we call pre-infarction angina or a heart attack, it is best that the procedure should be done immediately and can be a real lifesaver.

However, if your disease is stable the procedure may not be for you. A study published in the Annals of Internal Medicine showed that patients who had angioplasty stent procedures and took drugs to treat their coronary artery disease had the same risks of future cardiovascular events as the patients who only took drugs. It is clear to me in this situation that the risks of surgery with the procedure is not worth the potential reward. You will be much better making lifestyle changes, take targeted nutritional’s and your medications that support cardiac health.

What Is the Best Option for You?

Talk to your cardiologist; but I strongly recommend delaying surgery until you have the opportunity to heal yourself. By that, I mean trying alternative approaches and titrating up your medications as needed to improve your heart health, whether it is changing your diet, incorporating exercise in your life, or taking nutritional supplements, as well as increasing your medications. The key is to be open to helping yourself to heal.

Finally, I urge you to take periodic stress tests and be aware of any unusual symptoms you may be experiencing. If the nuclear stress test shows improvement in your blood flow, then you should continue to put off the decision to have surgery. I cannot tell you how many of my patients have healed themselves and they never had to have angioplasty or surgery.

Whatever option you choose, discuss it thoroughly with your doctors and get second or even third opinions. Remember, the path to a healthy lifestyle not only would help prevent coronary heart disease, but it is also to limit its progression. Unfortunately, I have had to recommend second surgeries to patients who considered an angioplasty an instant cure for their heart disease, only to return to an unhealthy lifestyle.

We physicians do our best to offer options, prescribe medications, and perform surgeries but you and only you have the power to truly cure yourself and make the most of the second chance surgery gives you.

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